Traditional
Indemnity Comprehensive Medical Plan
Our Comprehensive Medical Plan enables the utmost flexibility in choosing the doctor or hospital of your choice with no referrals required.
- Full benefits for inpatient hospital care for 365 days per benefit period with no deductible.
- Unlimited outpatient diagnostic benefit.
- Medical/Surgical benefit at 100 UCR (Usual, Customary & Reasonable) Schedule with a $200 individual deductible.
- Major Medical benefits up to $1,000,000 with a $500 individual deductible. Reimbursement at 80% up to $5,000 of eligible expenses, then 100% for the remainder of the calendar year.
- Prescription drugs covered under the Major Medical benefit and reimbursed at 80% after the deductible.
Forms and Documents
Application
Enrollment Change Form
Plan Summary
PICPA Traditional Benefit Summary
Rates
PICPA BC/BS Traditional
Plan Rate Letter